E. Wallack
Memorial University of Newfoundland Recovery and Performance LaboratoryAuthor Of 1 Presentation
P1097 - Femoral neck bone loss and increased fracture risk in people with progressive MS compared to matched controls. (ID 1417)
Abstract
Background
Disease activity has irreversible sequelae among people with progressive Multiple Sclerosis (MS), leading to permanent changes in body composition. Since there is emerging evidence to the role of body composition in both etiology and morbidity of MS, there is a need to characterize differences in body composition between people with progressive MS and age/sex-matched healthy individuals without MS.
Objectives
We aimed to compare bone, fat, and fat-free soft tissue (lean) mass in people with progressive MS and age/sex-matched healthy controls.
Methods
Fourteen adults with progressive MS (54.07+8.5 years of mean age) using gait aids and eight age/sex-matched controls without MS were recruited for the assessment using Dual-energy X-ray absorptiometry. The demographics (age, sex, body mass index, smoking status, and month/year of initial MS diagnosis), composition (bone, fat, and lean mass) of body regions (arms, legs, trunk, and whole-body), strength-related dimensions of the neck of femur cross-sections, and 10-year probabilities of an osteoporotic hip fracture and a major osteoporotic fracture were determined.
Results
People with progressive MS had significantly lower bone mineral density (BMD) on both left and right neck of femur (23% and 20% lower respectively) compared to controls (p values, <0.05). Neither fat nor lean mass was significantly different between MS and controls (p values, >0.05). People with progressive MS had a significantly lower cross-sectional area (25% and 19%), lesser cortical thickness (0.05cm and 0.04cm), and greater buckling ratio (39% and 33%) of both left and right neck of femur respectively compared to controls (p values, <0.05), but not sub-periosteal width, endo-cortical width, cross-sectional moment of inertia, and section modulus (p values, >0.05). People with progressive MS had 16 and 10 times greater risk of an osteoporotic fracture at the left and right neck of femur respectively compared to controls (p values <0.05). In MS, smaller cross-sectional area, thinner cortical bone, and greater buckling ratio at the left and right neck of femur were significantly related to a higher risk of an osteoporotic fracture at the hips (p values, <0.006).
Conclusions
People with progressive MS had significantly lower BMD and weaker bone architecture at the neck of femur compared to controls. The smaller cross-sectional area, thinner cortical bone, and greater buckling ratio at the neck of the femur were associated with higher fracture risk at the hips in MS.